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Organization
NICOLE LONG
Active
Organization
NICOLE LONG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE LONG (OWNER)
(508) 927-2464
Entity
Organization
Contact information
Practice address
150 WEST ST, WEST BRIDGEWATER, MA 02379-1448
(508) 927-2464
Mailing address
PO BOX 456, BROCKTON, MA 02303-0456
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
117186
MA
Other
Enumeration date
09/22/2013
Last updated
09/22/2013
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